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Background: Patients who have limb-length discrepancy demonstrate an altered gait pattern or a limp. The purpose of this prospective study was to compare the objective gait parameters for the shorter lower limb with those for the longer lower limb before and after lengthening and to compare these data with those for a group of twenty subjects who had no limb-length discrepancy. Methods: Eighteen patients had equalization of limb length to within one centimeter. We analyzed the stance time, the second peak of the vertical groundreaction-force vector, and the rate of loading with use of two force-plates arranged in a series. Results: The difference in the mean stance times between the shorter and longer limbs before lengthening was 12 percent, whereas that after lengthening was 2.4 percent; the difference between the values before and after lengthening was significant (p < 0.001). The difference in the stance times between the limbs of the patients who did not have limb-length discrepancy was 2 percent. Preoperatively, the mean second peak was 104 percent of body weight for the shorter limb compared with 116 percent for the longer limb; this difference was significant (p < 0.001). After lengthening, the mean second peak for the shorter limb increased to 113 percent of body weight. The difference in the means for the second peak before and after lengthening was significant (p < 0.001). With the numbers available, no significant difference was detected in the means for the second peak between the shorter and longer limbs after lengthening (p = 0.12). Conclusions: This study shows that lengthening of the shorter limb of patients who have limb-length discrepancy can normalize symmetry of quantifiable stance parameters and eliminate a limp.

The development of standardised, accepted criteria for the diagnosis, classification and grading of the severity of post-operative fibrosis of the knee will facilitate the identification of patients for inclusion in clinical trials, the development of clinical guidelines, and eventually help to inform the management of this difficult condition. Cite this article: Bone Joint J 2016;98-B:1479-88.

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